Asthma and allergies: is the farming environment (still) protective in <scp>P</scp>oland? The <scp>GABRIEL</scp> Advanced Studies

MacNeill, S; Sozańska, Barbara; Danielewicz, Hanna; Dębińska, Anna; Kosmeda, A.; Boznański, Andrzej; Illi, Sabina; Depner, Martin; Strunz-Lehner, Christine; Waser, Marco; Büchele, Gisela; Horak, Elisabeth; Genuneit, Jon; Heederik, Dick; Braun-Fahrländer, C; Mutius, Erika von; Cullinan, Paul

doi:10.1111/all.12141

Cited by 32 publications

(32 citation statements)

References 30 publications

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“…Observations linking exposure to green environments and agriculture to protection from illness were made as early as the 19th century by Blackley who noticed that hay fever was rare among farmers (78). This observation has now been confirmed in many countries using rigorous epidemiological methods (54,79). Moreover exposure to farms also protects from juvenile forms of inflammatory bowel disease (80).…”

Section: Natural Environment and Immunoregulationmentioning

confidence: 99%

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Regulation of the immune system by biodiversity from the natural environment: An ecosystem service essential to health

Rook

2013

Proc. Natl. Acad. Sci. U.S.A.

597

456

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Epidemiological studies suggest that living close to the natural environment is associated with long-term health benefits including reduced death rates, reduced cardiovascular disease, and reduced psychiatric problems. This is often attributed to psychological mechanisms, boosted by exercise, social interactions, and sunlight. Compared with urban environments, exposure to green spaces does indeed trigger rapid psychological, physiological, and endocrinological effects. However, there is little evidence that these rapid transient effects cause long-term health benefits or even that they are a specific property of natural environments. Meanwhile, the illnesses that are increasing in high-income countries are associated with failing immunoregulation and poorly regulated inflammatory responses, manifested as chronically raised C-reactive protein and proinflammatory cytokines. This failure of immunoregulation is partly attributable to a lack of exposure to organisms (“Old Friends”) from mankind’s evolutionary past that needed to be tolerated and therefore evolved roles in driving immunoregulatory mechanisms. Some Old Friends (such as helminths and infections picked up at birth that established carrier states) are almost eliminated from the urban environment. This increases our dependence on Old Friends derived from our mothers, other people, animals, and the environment. It is suggested that the requirement for microbial input from the environment to drive immunoregulation is a major component of the beneficial effect of green space, and a neglected ecosystem service that is essential for our well-being. This insight will allow green spaces to be designed to optimize health benefits and will provide impetus from health systems for the preservation of ecosystem biodiversity.

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Section: Natural Environment and Immunoregulationmentioning

confidence: 99%

“…2). This urban increase is true for allergies (53,54), inflammatory bowel disease (55), and for autoimmune diseases such as MS (56)(57)(58). These urban-rural differences are equally obvious in psychiatric disorders (59).…”

Section: Progressive Loss Of Microbial Inputsmentioning

confidence: 99%

Regulation of the immune system by biodiversity from the natural environment: An ecosystem service essential to health

Rook

2013

Proc. Natl. Acad. Sci. U.S.A.

597

456

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“…[8] Further, numerous studies report an inverse correlation for atopy for children who were raised on a farm versus nonfarm children, suggesting that farming is protective of atopy. [9–11] Interestingly, asthma and farming exposures do not consistently follow a similar trend, which is likely explained by the multi-factorial clinical phenotypes of asthma and the heterogeneity of farming exposures. [10]…”

Section: Farming Exposures In Children Is Protective: the Evidencementioning

confidence: 99%

“…The GABRIELA study findings to date have also highlighted other factors which may be important in understanding the correlations with atopy, asthma, and degree of protection. [9, 11, 14, 17, 18] The GABRIELA study group has found that the protective nature of farm exposures in Europe is not universal. A subset of Polish farm children within the GABRIELA studies did not appear to gain as much protection against the development of asthma compared to those children who lived on a farm in the Alpine areas.…”

Section: Farming Exposures In Children Is Protective: the Evidencementioning

confidence: 99%

Influence of farming exposure on the development of asthma and asthma-like symptoms

Wells

Poole

Romberger

2014

International Immunopharmacology

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Based upon age and type of farming exposures, a wide range of studies demonstrate either protective or deleterious effects of the farming environment on asthma. In this review, we highlight key studies supporting the concept that farming exposure protects children from asthma and atopy based on studies performed largely in European pediatric cohorts. Various types of farming in certain regions appear to have a greater effect on asthma protection, as does the consumption of unpasteurized milk. In the United State, where concentrated animal feeding operations (CAFOs) are more common, asthma is increased in children exposed especially to swine CAFOs; whereas, rates of atopy and allergy are lower in these children. We also review studies evaluating the role of farming exposures both as a child and/or as an adult on asthma seen in adults. The importance of microbes in farming environments and the contribution of various components of the innate immune system including toll-like receptors to the underlying mechanisms of asthma related to farming exposures are also reviewed.

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“…This comprised both obtaining further information from the parents and a qualified nurse taking a blood sample and nasal swab and performing a prick skin test on school grounds. These tests were conducted on a random selection of children from the group of 9,677 [26,27]. …”

Section: Discussionmentioning

confidence: 99%

Child’s assent in research: Age threshold or personalisation?

2014

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BackgroundAssent is an important ethical and legal requirement of paediatric research. Unfortunately, there are significant differences between the guidelines on the details of assent.DiscussionWhat often remains unclear is the scope of the assent, the procedure for acquiring it, and the way in which children’s capacity to assent is determined. There is a general growing tendency that suggests that the process of assent should be personalised, that is, tailored to a particular child. This article supports the idea of personalisation. However, we also propose placing limits on personalisation by introducing a suggested requirement of assent starting at a school-age threshold. In some situations RECs/IRBs and researchers could reduce the suggested threshold.SummaryA recommended age threshold is likely to serve the interests of children better than ambiguous and flexible criteria for personalised age determination.

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Asthma and allergies: is the farming environment (still) protective in Poland? The GABRIEL Advanced Studies

Cited by 32 publications

References 30 publications

Regulation of the immune system by biodiversity from the natural environment: An ecosystem service essential to health

Regulation of the immune system by biodiversity from the natural environment: An ecosystem service essential to health

Influence of farming exposure on the development of asthma and asthma-like symptoms

Child’s assent in research: Age threshold or personalisation?

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